Dr. Lauren B. Smith DVM
Original Content from Uncharted Veterinary Conference 2018

We’ve all heard about the death of expertise.  And if we haven’t heard about it, we’ve witnessed it with our own two eyes.  Clients come in with a diagnosis from Dr. Google long before they even step into the hospital.  They bring paper work from their breeders telling them under no circumstances to let their vet “sell” them on lepto vaccination because it will kill their pet. They tell us what medications they want before their animal has even been examined.
This isn’t just a veterinary problem, it’s happening everywhere.
Big Pharma is poisoning us to make a buck
Climate scientists are in it for the money
Lawyers are crooks (okay so that one’s not really new)
People today don’t trust “experts.”  They don’t trust us.  There are a lot of reasons for this, most of which I’ll leave to the sociologists.  But there is one reason in particular that I think resonates in veterinary medicine.
Powerlessness. 
We’ve always been relatively powerless to the whims of biology.  People and animals get sick.  No matter how many advances there have been in modern medicine, we still keep getting sick. But add in all the new ways we feel powerless in our lives—powerless to the politicians who govern our society, powerless to the big corporations that rule our economy, powerless to Mother Nature and the ever-worsening natural disasters that cripple our cities; and people are grasping for any little bit of control they can get.
Sickness is scary.  And when the health of you or someone you love is at the whim of someone else, it’s even scarier.  I experienced this first hand last fall when I got sick.  I had stomach pain and nausea.  I could barely eat.  I lived off matzo ball soup and sherbet for two months.  I had ultrasounds, CTs, MRIs, and endoscopies.  I got no answers. And it took an awfully long time to get those non-answers.  I had to wait for insurance clearance.  The first available endoscopy appointment wasn’t for over a month.  Eventually I just got better, but for those two months I was miserable, not just physically but emotionally too.
I thought of all the ways veterinary medicine was superior to the care I’d received.  I thought of all the things I did for my patients that were better then what I was getting, but also the things that I didn’t do but wished were done.  How could my doctors have helped to empower me and make me feel less out of control.
 

1. Create a rapport:  Don’t be a stranger to clients.  Let them know who you are.  Of course any of us who have been in general practice long enough have those favorite clients who come in on a regular basis, take great care of their pets and with whom we have established a relationship even above and beyond the medicine.  But that’s not the majority of the people we see everyday.  Many of our clients are strangers to us, and we are to them.  The great news is that we have ways to let our clients know us, even before they’ve ever met us.  Social Media is our friend.  People can develop a relationship with the faces they see on Facebook and Instragram every day.  They feel like these people are their friends.  So let it be your face they’re seeing.  Let them get a glimpse into who you are as a person and a veterinary professional.
   

 

1. Get on their level: No one likes being talked down to.  Literally or figuratively.  The first thing I do when I enter an exam room is squat down and let the dog come up to me while I talk to the client.  Now this is good for the patient who gets to feel you out a little but that’s not all it does.  First, clients love it when you get down on the ground because it makes them feel like you care about their pet and aren’t afraid to get a little dirty.  But is also literally puts you down below them when you talk.  They don’t feel like they’re being lorded over or condescended to.

 

1. Give them choices: I know there’s some debate about this topic.  And I’m not here to advocate for giving a client eight different treatment plans and letting them pick and choose, or even making certain diagnostics optional from the get go.  I’m talking about giving them a bigger choice—what are your goals for your pet.  When I have a really sick patient, that usually comes down to three things; we can go the whole nine yards; do a full work up, hospitalize, refer to a specialist.  We can treat palliatively and try to make the patient comfortable, or we can euthanize.  Giving a client these options before you come out with the $3000 treatment plan, lets them know that you’re not judging them and that you want to do what’s best for not only their pet, but their whole family.

We need to change the dynamics in our exam rooms to make clients feel more empowered and less defensive.  We need to break through the skepticism that’s holding them back from really trusting us. As long as clients feel like we hold all the power, they’re going to keep pushing back. 

This video is a collage of thank you's collected during a Dr. Ron Shaw's first year in practice!  What an awesome gift his practice gave to him for the anniversary. We all should sit for a minute a let our hearts and minds really bask in the joy of gratitude and a job well done. As driven, Type A , perfectionists we are skilled at self judgement and criticism... let's work on being gifted at truly hearing gratitude and praise.

A huge NOMV thank you to Dr. Shaw for sharing this piece of awesomeness!

by David Bledsoe DVM

Dear NOMV Nation,
By now most of us are aware of two recent celebrity suicides. These events have a tendency to focus attention to mental wellness and the additional dialog can be healthy and helpful. But it’s also a fact that such events can act as a contagion of sorts and may perversely increase acceptance of suicide as an option.

NOMV exists to provide a safe space for veterinarians to discuss and seek support for these issues. Our goal - as our name says - is that not one more vet will feel the need to take their life as a “solution” to their problems and pain.
PLEASE reach out to NOMV if you need to talk, vent, cry, or shout. Go to the NOMV anonymous post page if you want us to post anonymously for you. We are here for you.

Together we are stronger. We are not alone. We are ALLONE.
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On behalf of the admins and moderators, thank you for making NOMV what it is. 
David

If you are struggling, please do not hesitate to reach out to a NOMV moderator, or contact these numbers. Additional resources are also listed on this page: Support Resources
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Dr. Monique Koll

A few months ago I had made a commitment of 1hr/week of writing to NOMV. I managed that okay at first, and then, I was hit by Hurricane Harvey. I live just north of Houston and am a single mom living alone with my kid and pets, and to further complicate matters our 15yo Spanish exchange student had just arrived two weeks prior. But no biggie! I really wasn’t concerned. I had a quite serious boyfriend, but I was just fine on my own the way things were. I was renting my house, and besides I *really* didn’t think I was going to flood. I grew up in New Orleans so I’m an old hand to this flooding business, and it’s just stuff, anyway.

My son turned 11 on August 26, about a day before Harvey was scheduled to affect us, and the city was eerily quiet as we went out to celebrate. In the wee hours of the next morning, my boyfriend and I made the decision to pack the kids and pets up and leave. It would be no fun being stuck in my neighborhood, so we made a vacation out of it and went to Dallas for the weekend. We had so much fun!

I came back to find 8” of water had gotten in my house. It had mostly drained, and I had picked a lot of my stuff up, but the carpets were ruined, the insulation inside the walls were ruined, it was too early to tell about my piano yet and we couldn’t stay there, at least right then. I did the best thing for the house; we stripped out the carpets right away, started cleaning up. The landlord didn’t want me to do the sheetrock at first but I convinced her. My kids pets and I could stay with my boyfriend so no big deal, but he lived 30 minutes away, and they still had to go to same school and I still had to work, so I was super determined to get back in my house asap.

It didn’t work out that way. Under Texas law, I had the right to abandon that rental and get my deposit back, but it’s not what I wanted. I wanted to move back in asap. My friends and I worked really hard on the house, but the landlord still did not want to give me enough of a break on the rent to make it worth it. We did thousands of dollars worth of work, but the landlord did a shoddy job to get it together as cheap and as quick as possible. They did not remove the cabinets to remove the wet insulation behind them. They replaced the floors with cheap tile.

So then,, I’m waking my kids up at 5a, driving them to the bus stop 30m away, driving to work also 30m away for my 12 hours shift, repeating in the evenings. I work as an emergency veterinarian and we were busy, no rest for the weary! I was not happy anymore about moving back into that house, and life as it was was not sustainable. My exchange student was contemplating living with someone else. My son couldn’t attend Cub Scouts or anything after school. Sure, it is “just stuff” that I lost, but now what? It was easy to sink into depression for sure.

It was time to make some big decisions that I wasn’t ready to make. Fighting depression, for me anyway, means changing my circumstances. This is not always feasible, I know! In this case though, I made the huge financial leap and decided to buy a house! With the recent flood I was scared the market was going to skyrocket, and I wouldn’t be able to afford rent anyway. At that point, my boyfriend and I discussed our future. Buying a house now meant either buying one again in a couple of years if we were really going to move in together, or him and his kids moving in on my turf which would be less than ideal. In what was not the least stressful decision but maybe the one that made most sense in the long run, we decided to get engaged and buy the house together. Living with someone all of a sudden isn’t easy, especially since we were both just fine by ourselves, never mind four kids under one roof. The house-buying process was a whole other headache that I don’t want to relive enough to type. BUT, it worked! We are now in a house we love, in a neighborhood we love, where my kids can get to their school easily and attend all activities they like. I am engaged to the man that I love and we get to start our lives together earlier than we ever expected. I am not one to think things happen for a reason, but good can come from bad, and I am so thankful and fortunate that it did for us. We are not unscathed, financially or emotionally or otherwise, but I still have my job and my family and now a beautiful home that I own.

I know a lot of veterinarians in my city that did not make out nearly as well as I did. There is so much chaos and pain in our area still. It was wonderful seeing the community come together to help people and their pets. My son and exchange student grew so much out of it, and gained a sense of societal responsibility that they may never have had before. I’m still thinking of all of you that are still struggling with this disaster. Please let me know if there is any way that I can help you.

Monique Koll, DVM

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